Sexuality education among black South African teenagers: what can reasonably be expected?

Incidence rates of teenage pregnancies in South Africa--especially among the black population--poses definite reason for concern. The adverse physical, psychological, social and demographic consequences do not only put the lives of the mother and infant at risk, but also threatens the quality of their lifestyle. Sexuality education is not a panacea for preventing teenage pregnancy, but within a multi-disciplinary approach evidence indicates that it has an important and ameliorative role to play in successful preventive programmes. The practical aspects of the delivery of sexuality education, particularly in comprehensive health clinics in black areas, raises questions regarding the expectations to be attached to such services. A partial answer is provided by a preliminary study conducted in two South African townships. The study highlights some of the issues impeding the effective functioning of sexuality education services in clinics. In order to address some of these problems, the author contends that sexuality education should be synonomous with effective two-way communication. This implies a high degree of co-operation between policy makers, nurses and black teenagers. This link between communication and sexuality education will be referred to as SEC (Sexuality Education as Communication). Within this framework a cognitive-behavioural approach as a four-step process to learning, holds potential to incorporate most of the requirements for SEC. The attitude and ability of the nursing staff is of crucial importance in all four steps, as the SEC model continuously emphasizes the relationship between adolescents and the nursing staff. There is almost universal agreement that the educator is the key element in good programmes.